On the guidlines for when to start treatment, it says that this should be considered if you have "serious symptoms"; is shingles a serious symptom? If I have shingles does that mean I will have to start medication?
No, not necessarily, particularly if the bout of shingles is routine, i.e. limited to one specific area on one side of the body. Talk to your HIV doctor. He should be your best resource as to when to consider beginning anti-HIV medications.